Fibromyalgia and Broken Promises

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Her face falls and her shoulders slump.
“I’m really sorry, honey. I’m just hurting way too much.”
“Okay,” Rachael responds, shuffling away from me. She understands. That somehow makes it feel worse.

The annoyed sigh that I expected Mike to breathe comes through the phone.
“Okay.”
His response is terse. It’s not that he’s mad at me and is going to be a dick about me calling him to come home. Mike understands that a component of fibromyalgia is chronic fatigue and that, even though I said he could stay for game night, the day has become too much and I need his help. But it still doesn’t suck any less for him or make me feel any less guilty when I have to pull the rug out from under his feet.

Text to R:I’m sorry. I’m have to cancel today. Zoë was up half the night.

Text to J:I’m sorry, but I physically can’t keep my eyes open today. Mike is going to bring Rachael instead.

It seems that I’m always breaking promises and letting people down because of this damned chronic illness. I’ve learned to compensate by under-committing and making “hopeful” plans. I almost never promise my children anything anymore, just so I don’t have to break their hearts along with my promise. Language like, “We’ll try,” or “We’ll do our best,” has also become part of Mike’s vocabulary. He, too, knows better than to assume our plans won’t fall through at the last minute.

I hate breaking promises. I hate that, compared with my old self, I have become an unreliable, under-productive woman. Fibromyalgia recklessly rampages, unplanned and unannounced, not caring who is caught in its wake. I know that, for others, it must be difficult to separate fibromyalgia from me. I sometimes still have trouble making the distinction. But it’s not me who is letting everyone down; it’s the fibro.

I’m sure it may be difficult to understand that I can’t always manage my own illness. Surely, if I know flares are possible, I should be able to plan accordingly so I won’t have to break any promises.
That’s only partially true.
I know I need to plan on being wiped out for a week or two after a trip. I believe it took me 3 weeks just to recover from Christmas. I generally avoid planning more than one thing in a day. For instance, my trip to the dentist on Monday left me feeling as though I’d run a marathon, minus the shitting myself component. I avoid making plans with anyone after 5 pm. My body is generally done, physically and cognitively, by then. I even tend not to let my kids in on plans until they’re about to happen. Given the nature of this beast, it makes no sense to plan for a friend to come play after school ahead of time, as I’m usually useless by 3 pm.

Still, even with all this planning and compensation, I can be suddenly attacked with flares. Sometimes I can explain them, e.g. weather events. Sometimes I’m waylaid and left thinking, What the actual fuck? Where’d this come from? These flares are not simple mind over matter moments. I can’t overcome them by simply refusing to be a pussy and soldiering on. All I can do is take care of myself and let it run its course. And part of taking care of myself sometimes includes breaking promises.

Part of what prompted me to write this today is that Rachael and I have plans to go see Into the Woods today. Because of all the weather systems coming through, I’ve been in horrible pain this week. I feel like I’ve been walking on broken feet. My back and shoulders are compressed in a vice. And this morning I woke up feeling like my neck had been in a knife fight. The thought of holding my neck to watch a movie for 2 hours sounds like torture. But I took as many drugs as I safely could and hoped the pain would subside by movie time, because I’ll be damned if I’m breaking another promise to my little girl.

A Spoonie Does Disney: Part 5

This is the final part of a 5 part series about my experience, as a spoonie, vacationing at Disney World. Here are parts 1, 2, 3, and 4.

I discovered that my love for roller coasters has become tainted. I’ve never been one for the fucking insane most adventurous rides, but I do love a good zero to OMGWHEEEEEEE! with the upside downs and sharp banking. So it was disheartening to find that I was really going to have to suck it up and take some real pain if I wanted to ride the coasters at Disney. (And the ones I rode at Universal Studios at the conference block party. Consider wearing body armor if you’re going on Transformers or the Minion rides.)

The first coaster we rode was the Aerosmith RocknRoll coaster. First of all, holy crap on a cracker, y’all! I think that coaster would have been rough, even without the fibro. It was pitch black for the first 10+ seconds of the ride. I made my throat sore, screaming for my life during that coaster. It ended up being fun, but holy shit was it rough on my neck. The same is true of Star Tours, Everest, and Space Mountain. All a lot of fun, but are murder on the neck and back. The new Seven Dwarfs Mine Cart coaster was fun and much easier on the neck. It didn’t leave much room for my legs, which made for a lot of pain around the curves, as my legs and knees mashed into the lap bar.

Ultimately I would have been sad if I had let my fibro be in charge and hadn’t gone on any of these rides, but the price is pretty steep. I said “shit” and “fucking ow” as much as I laughed and said “whoo”. Drug up in advance, people!

Line up, everybody!
After my experience of standing in line for Soarin’, I wanted nothing to do with standing in any line for very long. If we couldn’t fast pass something, or the wait was longer than 30 minutes, we just didn’t do it. We did a fast pass for the Aerosmith coaster, so not a big deal. We hit a big snag in our plan when we arrived at Everest at Animal Kingdom. No fast passes were available, and waiting in line was going to be almost an hour. But then, an awesome cast member at the fast pass kiosk told us about the single rider line. It’s one of the few rides in Disney where you can get in a separate line if you’re planning to ride by yourself. You become a seat filler with the odd numbered parties who all want to go together. Mike and I ended up on the same coaster, just different cars, and only waiting about 10 minutes! I’ll be honest, when we started going backwards in the dark, I wish I had had Mike’s freckled arm to squeeze until his arm would break. But overall, it was really fun and we were able to cross that coaster off our list.

At the new 7 Dwarfs Mine coaster, waiting in line for an hour was just fine because I had my wheelchair by then and the line was wheelchair accessible. But, as is the case with many older buildings and walkways, Space Mountain’s regular stand-by line is not wheelchair accessible. So a cast member directed us to the fast pass line to get a return time, as the new fast pass line is wheelchair accessible. I think they wrote the time down wrong. Rather than an hour wait, we only waited 15 minutes. Make sure that whomever is pushing you up and down the steep angles the fast pass line takes is in peak physical condition. Mike was a trooper, hoofing it up those inclines and preventing me from become the physical comedy trope of a person in a runaway wheelchair on the downward slopes. At one point, the rubber grip on one of the handles came off while going downhill, which made things interesting. After we managed to avoid fiery collision, Mike parked me and went back up the line to find it. It’s terribly awkward to be sitting by oneself next to a line of other people. I should have started quacking to emphasize my current state and make everyone feel better.

After our arduous journey over hill and dale for many a fortnight, depleting our skeins of Tang and supply of freeze-dried lembas bread and limbs quivering from all that they had to endure, we finally reached a place of rest on the Mountain of Space. There we found rest from the kind mountain villagers, who prepared us for the next phase of our fantastical journey. We hobbled toward the space pod, which would carry us to our destination, only to find our path blocked. Downcast though we were, we found comfort in the continued care of the villagers. The town crier regularly took to the village main square to announce how the work to clear our way goeth. As I rested in my transport, I felt the growing unrest from a faction of villagers. I worried that their dismay would turn toward me. After all, had I not walked from my transport to the space pod? Had we not taken our place in line before those who had waited what seemed like lifetimes? But we stayed the course, stalwart and sure, for the road had been hard and our journey far.
But what to my great joy when the town crier sent forth word that the way was open and our journey into the stars was to recommence! Into our pods we settled; such great anticipation leaving all aquiver. We began, and the wind blew my hair. I felt the chill of dark space fill my nostrils and promise thrills beyond imagination.
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Wikimedia Commons

Suddenly, cool, blue light flooded the sky. We were enveloped in the beacon that was foretold, the beacon that would let all who passed know that their hard work could be put to rest. It was time for the prize for which we had waited so long.

And then we zoomed around in the dark. It fucking hurt, but damn it was fun.

Why Spoonies Give Up

I decided that I had enough with my rheumatologist, (the second one I’ve tried thus far.) But who was going to manage my fibromyalgia care? I decided to try a medical group who has a special fibro care program, something that isn’t very common. Also available is complementary medicine and a med spa for massages and such. I called this week, told the scheduler why I wanted an appointment, and she told me the earliest appointment available was Saturday at 4 pm. Great!, I thought. This way Mike won’t have to work from home for me to go to this appointment alone.

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Image source

I wish I could go back in time and smack that scheduler up so she wouldn’t have set up a huge waste of time for me. It was abundantly clear that this doctor didn’t feel like being there at 4 pm on a Saturday. He also had no. fucking. clue. as to how to medically, (or relationally) treat someone with fibro. I’ll just do bullet points for how the appointment went.

– He didn’t take or look at the patient history, labs, and other test results I took the time to put together so as not to waste his or my time.
– It was pretty clear from his tone of voice that he didn’t understand why I had left my two previous rheumatologists. It was like he didn’t get why I thought my experiences with them were bad ones.*
– Diarrhea of the mouth began. Without asking any of my habits, he immediately launched into how people with fibro need exercise and I can’t spend all my time laying on the couch. I have to “use it or lose it”. I informed him that I have two young girls; I don’t spend all my time laying on the couch.
– He asked the basic “duh” questions: Where does it hurt? Is it joint or muscular? How’s your stress?
– He mentioned a few complementary medicine procedures, but then said he wouldn’t do any of them because it would hurt or it weirded him out.
– He told me that doctors don’t really know what to do and how to treat fibro.
– He criticized me for having to bring food in a lot for dinner, after I explained that I can’t cook as much as I used to because it hurts to stand in the kitchen for that long. It was mostly because he was concerned for the health of my children. (I explained that it’s just for Mike and me; we feed the kids different food from home.)
– He wrote an order for a sleep study. Rather than recommending a place, he told me they were everywhere and to just pick one.
– He said that the medicines I was on were about the most they could do for someone with fibro. He said that they do what they can medicinally, and then the patient just has to learn to live with the pain. I believe it was the long-winded version of “Suck it up”.

Finally, I just cut him off and told him what my treatment goals were. Specifically, I wanted to try any natural options available to cope with or alleviate pain. He referred me to their two naturopaths for that. He told me I would need to bring my big girl veins for the first appointment because they were going to draw a lot of blood because the naturopaths test for everything. He said going through that would be enough to make him not want to do it. I stood there in the room, arms crossed and staring him down. I was filled with rage, exhaustion, incredulity, and defeat. I screwed up my face and set my jaw so that I wouldn’t cry. That would be for when I reached my car.

Can you imagine if that had been my first doctor’s appointment for fibromyalgia? Can you imagine if I wasn’t confident in myself and my diagnosis? The ignorance and arrogance of our doctors can be a lethal combination for timely and appropriate help. So many journeys are stopped dead in their tracks because an insensitive doctor acts as though the patient’s problems would all disappear if they just took a walk everyday. Patients aren’t always open and honest with their healthcare providers for fear of being ridiculed, shamed, or made to feel crazy. When we feel as though there aren’t any safe havens, we stop trying. We end up enduring more pain than we should because the thought of another useless or abusive doctor’s appointment is more painful.

In this day and age, it is appalling how ignorant doctors can be when it comes to chronic pain. Millions of people live with it yet, only now, are syndromes like fibromyalgia beginning to be viewed as legitimate. Doctors who went to medical school more than five years ago, or don’t have any special focus or training with regard to chronic pain, are clueless. In my experience, cluelessness in doctors leads to doubling down on their ignorance and how much of a dick they are to you or how dismissive they are of you and your symptoms. Put simply, if they don’t know what to do with you, they don’t want to deal with you.

With such attitudes within the general medical community, it becomes incumbent upon spoonies to be their own advocates. We must surround ourselves with the support of loved ones and those who are on the same journey. We need to support organizations, like the NfmCPA, who amplify our voices when it comes to lobbying Congress for research dollars. We need to let our healthcare providers know when changes need to be made and not just accept whatever is handed to us. I have hope that the medical community will learn to help us. But we can’t just wish upon a star and dream. We have to make it so.

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*The reason I left my first rheumatologist:
At my first appointment, he prescribed trazadone to help me sleep. After a couple of doses, I began having intense suicidal thoughts and found myself yelling, out loud, to shout down the voices in my head telling me to kill myself. This ended up happening on a Saturday, so I left a message with a live person through the answering service, asking what I should do. I never received a call back. My primary care office ended up helping me out.
At the next appointment he fussed at me for calling on Saturday, I guess because I’m supposed to schedule my drug-induced mental breaks durning office hours. During that appointment he said he wanted to step down the Lyrica and replace it with Topomax. I asked if there were any side effects I should be concerned about. He shrugged and said, Only if you have glaucoma. When I got home, I researched Topomax. It looked like there was a possibility of some pretty horrible side effects. After that, I was done. The trust was broken, and I can’t have a professional relationship with someone like that.

The reason I left my second rheumatologist:
I actually stayed with her for about a year. I liked her at first. But it didn’t take long for the things I didn’t like about her to outweigh the good. She never remembered what we had talked about previously or what I was taking. I swear, she must have asked me if I had tried Neurontin or was taking a yoga class at three consecutive appointments. It was very difficult to get a word in edgewise with her. She tended to just steamroll you with her agenda. It seemed as though drugs we the only thing she cared about as far as treatment. The time I asked about natural options, she just handed me a pamphlet for a vitamin mix that is supposed to help with fatigue. And my weight. She was so fixated on my weight. No, I’m not a small girl anymore. The Lyrica and cupcakes made sure of that. She was bound and determined to get me on thyroid medication, even though my labs show that my TSH levels are within normal limits on two consecutive tests. (She also sort of fussed at me because I had my separate T3 and T4 levels tested when the order was just for TSH.) I expressed my unwillingness to add another medication to my cocktail while my levels fell within the normal range. She told me to take it and get yet another thyroid test. She also, again, told me that low thyroid will cause fatigue and weight gain. I’m like, you know what else causes fatigue and weight gain? FIBROMYALGIA AND LYRICA! I felt like I went with her as far as she could take me, so I’ve left. And I’m not the only one. I know others who have seen her and left because of her nonsense.

No one ever expects the mole!

When I suspected, and was finally diagnosed, with fibromyalgia, I thought I knew what that meant. I was going to be in some amount of pain for the rest of my life, along with an extra helping of mind-numbing fatigue. I checked with my Parents with Pain group, and it seems that I am not alone. We were all completely blindsided with various bizarre symptoms. It’s a cruel game of Whack A Mole; different symptoms and disorders pop up when you least expect them. And at times we feel like the moles have revolted, grabbed ahold of the mallet, and start to beat us back.

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Image by ccc7ccc at Deviant Art

Here is a list of just some of the bizarre indignities and medical nightmares we fibro people are forced to endure.

Muscle spasms
I think it’s safe to say that everyone has experienced some sort of muscle spasm at some point in their life. They range from tiny twitches in one’s fingers to backs seizing up, because you didn’t have anything better to do that day, did you? In hindsight, I realize that I experienced my muscle twitching years before I even knew that fibromyalgia was a thing. They start small, almost indiscernable, just a thumb barely moving involuntarily. When you try to show someone else, they don’t see it. You feel stupid and they decide you’re an attention-seeking idiot.
But now, there’s no denying the sudden moves my fingers make. Sometimes they keep me up at night. All to often, I’ll have almost drifted off into dreamland, when my index finger decides that it would rather point at my headboard. The stomach spasms are ones I never expected. It feels like being pregnant all over again, or like I’m incubating a tiny kick boxer.
It’s also way too easy for my muscles to spasm and stay locked so that I can’t move. I have literally looked the wrong way at the wrong time and landed myself in bed for two days because moving my neck was impossible without screaming bloody murder. On the plus side, it gave me time to watch and become addicted to Sherlock.

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I’m so glad Molly is also sick of my muscle spasms.

Night Sweats/Temperature Sensitivies
Sometimes I wonder if I should just bring a squeegee to bed with me. It doesn’t matter if I’m barely dressed and uncovered, I will still wake up in the middle of the night, drenched. Once I’m able to peel my face off my soaked pillow, I wipe off the small lake that had accumulated between my legs. There are plenty of good reasons to be wet in between your legs. This is not one of them.
To go along with the night sweats, sweating in general has become a thing. My fellow fibro folks have recounted tales of walking from their car to inside of a store and finding themselves turning into puddles. For me, the best part is stepping outside and immediately having a sweat mustache and soaked hair all around my hairline.
We also deal with sensitivity to cold. Along with being in more pain when it’s cold outside, my body has now decided to freeze at 73 degrees like it were 33 degrees in the house. I have heard other spoonies say that heat and humidity make their pain worse. Some of this is due, no doubt, to…

Swelling
The only time anyone should wake up and not feel alarmed by their giant hobbit feet is if they are, in fact, a hobbit. Tight, swollen feet are uncomfortable all by themselves without adding the enormous feat, (see what I did there?) of walking. Normally slender fingers also turn into sausages, making it difficult and painful to engage in normal activities…like picking up a cup to drink.

We can’t stay in one position for too long
One of my spoonie comrades said that if she stays sitting for too long, her tail bone swells. Sometimes with fibro, you just can’t win. If you lay down and rest for too long, it’s murder to get up and put weight on your feet. I have seriously felt like I was in some sort of physical comedy show where they immediately collapse upon standing. It’s so funny that you laugh until you cry….and cry….and cry until you ugly cry so that snot is all over your face and now you have a massive headache and have to try and stand up yet again. Ahem.
So, just don’t lay down, you might say. That’s all well and good, except, after standing for awhile your legs become tired and sore. Perhaps your back also gets in on the action. Soon after, your hips are like, Fuck this, I’m out, and give out on you so that you’re unable to put weight on them, which forces you to limp everywhere.

Neurological issues
Dizziness is pretty common. Fortunately for me, I don’t experience it constantly. But when I do, it is one of the worst feelings. Have you ever seen someone swirl soft serve ice cream or frozen yogurt onto a cone? When I’m dizzy, I feel like I know what it’s like to be that ice cream. I feel a sudden whoosh upward, starting at the bottom of my head and quickly swirling upward, so that my whole head is engaged before it’s over.
I consider myself to be a decently intelligent human being. However, all too often you’d never know it because of how stupid fibro makes a person. As a dear friend used to say, I can’t brain today. I have the dumb. Everyday, we wend our way through thick, goulash fibro fog. Once upon a time we may have been able to organize our thoughts easily. Now, they flutter out in foggy space as we try to corral them with slow-moving nets. We have difficulty finding, (or as I say, making) words. Sometimes we’re like a fibro-ridden Tantalus; words are there, just out of reach, and we are unable to grab them and send them to our tongues. Other times, they completely elude us.

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We become hypersensitive to stimuli. Screaming children pierce our eardrums. Too many people talking or things going on at once overwhelm us and make us want to cover our ear, close our eyes, and shut down. Sensitivity to light, smells, and startling events just add to the cacophony of stimuli issues.

Itchy, itchy, ITCHY!
I’m highly allergic to poison ivy. At Rachael’s first birthday I had it so bad that it almost took over my eye. I’ve also been introduced to the misery of PUPPPS. I had it for 20 weeks, (no, that’s not a typo) while I was pregnant with Zoë. Rather than just being confined to my belly, it was all over my body: my face, my neck, my arms and hands, even my butt.
None of this prepared me for the ridiculousness that is fibro itching. Without warning, it will suddenly pounce, sending you on a scratching frenzy. And it doesn’t stay in place. Oh no. It likes to play itchy tag. Now I’m on your leg! Yoohoo! Over here, on your butt. Ooh, I haven’t been to your palms lately. My itch attacks generally strike when I’m trying to go to bed. They also really like to torture my feet, which makes quietly scratching so as not to disturb Mike as he’s falling asleep nigh impossible. I’ve broken the skin from the intensity of my scratching.

Costochondritis
Costochondritis is a comorbid disorder that manifests itself by the swelling of the muscles in your chest. If you’re not familiar with the pain, you will worry that you’re having a heart attack. In fact, I feel like I’m playing heart attack roulette every time I have an episode. I worry that one of these days it will actually be a heart attack that I have written off as costochondritis. Moving and breathing during an episode intensify the pain. Stress also makes it worse. I take prescription strength anti-inflammatory twice a day to stave off the pain. And now I worry that some day my wrecked intestines will bitchslap me for it.

Interstitial cystitis
Imagine feeling like you have a urinary tract infection all. the. time. That’s the awesome that is interstitial cystitis. I feel like I live in the bathroom with the number of times I pee in a day. I just peed five minutes ago, and my bladder is already hurting. I often sit on the toilet for several minutes, just waiting for my body to let it go.

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Original image by lollipop at Deviant Art

Seriously, you could create a fade time lapse sequence while I sit and wait to pee. First, looking around to see what’s new in my bathroom, (nothing) and deciding if I want to paint the walls a new color. Fade to clipping and filing my nails. Fade to checking Facebook and Twitter. Fade to rage posting something from Jezebel. End sequence with me pushing out the pee like I’m giving birth. Aaaaaand, scene.

There you have it, folks. A not even nearly comprehensive list of all the extra BS we spoonies get to endure along with the pain and fatigue of fibromyalgia. I’ll end it here because I don’t want to bore you to death. Also I have to pee….again.

There is no shame in depression

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Thinkstock images

Recently, I joined the Parents with Pain Facebook group. It is so wonderful to have another positive way to connect with people who are in the same situation. During one of our discussions, several women shared that, in addition to their pain, they lived with depression and, at times, suicidal thoughts. This didn’t surprise me, as chronic pain and depression are typically comorbid conditions. What did shock me was how unsupportive their husbands/partners tended to be with regard to my fellow spoonies’ physical and mental pain. This seemed especially true whenever this involved sharing the experience of depression and suicidal thoughts with others. Words like “ashamed”, “pride”, “stigma”, “embarrassed”, and “mental cases” stood stark on the page, pushing aside the other words to reveal sorrowful secrets. They described the reactions and perceptions of these partners. I was shocked because I had never experienced this in my marriage; Mike has always been my biggest cheerleader. We’ve had plenty of bumps on the road of sorting out this new way of life, but Mike has always been beside me as we were shaken and jostled about.

Allie Brosh and NPR
Last year, I was excited to receive Allie Brosh’s book, Hyberbole and a Half, in the mail. I loved her web comic, (Adventures in Depression and Depression Part 2 are a must read) but her interview with NPR made me want her book all the more. In the book, she shares her journey with depression.
(I say “with” rather than “through” because, as anyone who has experienced long-term depression knows, it’s not some horrible houseguest who wrecks your weekend and grocery budget. It’s more of a permanent travel companion who wants to listen to horrible emo music and cover your eyes while you drive. Sometimes you can relegate it to the backseat or the trunk, but it’s always with you.)
During the interview, Allie explained that, at her lowest, she no longer wanted to exist. She didn’t necessarily want to kill herself, just somehow fade from life.
This so perfectly described me at my lowest. Because of all the physical pain, stress, and fatigue of fibromyalgia, I colorlessly admitted to Mike that I wished I could just blink out of existence so I would no longer feel the pain and hopelessness. I’ve wanted that option mostly because I’m too scared to actually kill myself. (It also takes the responsibility out of my hands.) I’ve stood at my sink with the sharp knife I’ve just washed. I’ve held it over my wrist with the faucet still running, recalling from The Craft the proper way to do it. And then I wonder how far I’d actually get before yelling, Ow ow, fucking ow!, and then just have a bloody mess, a big ER bill, and an exclusive, one-way trip to the psych ward of the hospital. I’ve thought about overdosing and stepping into traffic. I’ve laughed through tears that I wished I were dead because, then, I’d get some good sleep.

Through all these things, Mike has been supportive. He’s listened and understood. He’s urged me into therapy and reminded me to see my doctor to adjust my meds. Not once were words like get over it, all in your head, or don’t tell anyone uttered. And thankfully, he’s never given me any articles or books about the 5 Habits of Happy People or some other nonsense, otherwise I would have smashed his Adam’s apple when I throat punched him.

He never said anything like that because of one simple fact:
Depression and suicidal thoughts are not things anyone should feel ashamed of.

(Ending a sentence with a preposition? Maybe.)

They are not things that are fixed by Cher yelling, “Snap out of it!” It is not your fault that your brain chemistry works this way. For me, the thought of dying allowed me to realize that I don’t want to miss growing old with my husband, taking over helping with the planning of my daughter’s weddings, and spoiling my grandkids. Going to that dark place, without fearing shame or stigma, was a chance for me to sort through those thoughts and feelings head on and get the help I so desperately needed.

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If you are in the grip of depression, please please PLEASE do not let the fear of shame prevent you from seeking out the support you need. If your partner won’t help, see your doctor, talk to a friend, or join a support group. There are more of us than you realize. You are not alone. When more of us emerge from the shadows, more light is able to pour in and drown all the lies of suicidal thoughts and depression. And if someone tries to shame you for your depression, tell them to just get over themselves.

Motivation is a double-edged sword

I’ve been more depressed lately. I could tell because I was becoming more withdrawn, more exhausted, and more screamy. My motivation to do anything had also taken a nose dive. I knew it was time to see the doctor again to increase or change my meds. First, I saw my primary care doctor, who had prescribed Cymbalta in the first place. She told me that studies show that the efficacy of Cymbalta didn’t change with an increase in dosage from what I was taking. I also asked for, and received, a referral to a psychiatrist. It was time to take it to the next level.

When I met with the psychiatrist, I mentioned what my primary care had said about the efficacy of Cymbalta in dosing. She screwed up her face like it was the dumbest thing she had ever heard, (in response to my primary care, not me) and said that it does work past where I was, otherwise they wouldn’t make doses that go up to 120mg. So, she increased my dosage and got me set up with a therapist in the office for talk therapy.

Holy crap, was my primary care wrong. Increasing my Cymbalta has been a big ole bag of helpful. I feel happy and the desire to be engaged again. I’m less fatigued and a little more clear-headed. My patience doesn’t deteriorate to shrieking flying monkey in 2.3 seconds now. And I feel motivated, whether it be to engage in relationships or do things around the house. Yesterday I finally took the initiative to clean up our basement steps, where everything to go downstairs gets dumped, and put together the shelving I bought.

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This is what classy, non-hoarding organization looks like.

This motivation to engage in normal life comes with a price, though. While the increase in Cymbalta makes me feel better, the fibromyalgia is still ever-present. I’m still fatigued and I’m still in pain. The newest incarnation of pain is in my feet and ankles. Everything is swollen, it feels as though my legs are crushing my ankles, and it feels as though the bones in my feet are slowly breaking every time I try to stand and walk. The pain reminds me of the time Mike and I went to see Spamalot in DC. I had fantastic shoes to go with my dress. Unfortunately, what I didn’t realize when I bought them was that they were so fantastic, the pain of wearing them would leave me standing barefoot in Metro Center. It’s too bad I can’t hang my feet on my fingers like some cute, strappy sandals.

I’m sure this has been made worse by all my Cymbalta-assisted flurry of activity. It’s really hard to see all that there is to do, have the motivation to do, and force myself to sit and rest because my feet are being little cunts. But that’s exactly what I’m trying to do today. I have pain patches attached to my legs, ankles, and feet, and I’m taking breaks from being on my feet. So far, it seems to help if I do chores in short bursts; I’m accomplishing tasks without over-taxing my body. At least, that’s the status as of now. We’ll see if that continues throughout the day. The goal is to have the ability to stand long enough to cook dinner at the end of the day.